The advantages of laparoscopic surgery have made this technology the preferred choice for most surgeries. 95 percent of cholecystectomy were performed laparoscopically. However, due to the nature of laparoscopic surgery, intensive training is required before the surgeon is confident to perform the surgery on patients. Traditionally, surgical training is done with the ‘master-apprentice’ strategy. The trainee surgeon has to learn the surgical procedure by repeating the steps as performed by the master surgeon after having observed his/her master surgeon performed it several times. Some times the master surgeon has to “hold” the trainee's hands in order to show the trainee a subtle movement. With increasing complexity of the surgical operations nowadays, it becomes increasingly dangerous for the trainee surgeon to ‘learn’ while operating on a real patient despite being supervised during the operation.
Currently, there are several surgical simulation systems that provide training features to build fundamental skills for laparoscopic surgery. Although operative scenarios are provided in the surgical simulation instruments, there are some limitations. These include the lack of varieties. Certain maneuvers by an experienced surgeon cannot be easily taught to the trainee surgeon. Current simulation systems are passive in nature, and hence, act as a practicing environment rather than an active teaching tool. A good surgical training system is associated with rapid learning curve among experienced surgeons from multiple surgical disciplines. It should transfer the experiences from the operation room to other surgeons, and hence, sharpen the surgical skills of surgeons.
LaparoscopyVR and Lap Mentor II developed by Immersion and Simbionix respectively provide facilities to gain hands-on experiences. However, these training methods are designed for medical staff with some basic skills and experiences in laparoscopic surgery. Since all motions of the surgical tool are passive without motion guidance, the trainee surgeon has to perform the task based on his/her own skills. The simulation instruments are incapable of providing active teaching, since the simulation instruments do not provide physical motion guiding.
Xitact™ IHP, developed by Mentice, is a haptic simulation hardware for minimally invasive surgical procedures, such as laparoscopy, nephrectomy, arthroscopy, and even cardiac surgery. Action and reaction are synchronized so that the resistance of an actual organ is recreated in the ‘touch’ sensations experienced by the user. Although the motion of Xitact™ IHP is tracked, the Xitact IHP does not actively drive the surgical tool to move autonomously, therefore it is not able to provide active guidance to the user. As it is incapable of varying the force output, the haptic feedback for tool-tissue interaction is not realistic.
EndoBot, developed by Rensselaer Polytechnic Institute, is designed to assists surgeons during minimally invasive procedures. The model of motion of EndoBot can be passive and active, and the EndoBot provides with encoder for tracking of motion, but it does not provide haptic feedback. The robot is able to assist the surgeon to complete some specific tasks, such as suturing, or constraining manual suturing in certain path. The robot does not provide any feature in training. Although the mechanism is designed with mobility that mimics the kinematic motion of a laparoscopic surgery device, its actuating mechanism is meant to be driven by motors with high torque range like most assistive devices. For instance, the use of a lead screw thread for the translational axis makes back driving difficult when the device is in passive mode.
U.S. Pat. No. 7,023,423 “Laparoscopic Simulation Interface” proposed a method and apparatus for laparoscopic surgery training interface. The use of its gimbal mechanism for pitch and yaw control of the tool can provide structural stability, but compromises on workspace efficiency. The mechanism was designed such that parts of the linkage can be exposed beyond the incision point marked by the intersection of the two pitch and yaw axes. The intrusion of mechanical linkage into the user operational workspace is undesirable in a user-centric simulator. Also, the pitch and axes are each achieved by connecting three members “in series”, which requires a large work space for implementation, and may increase the possibility of mechanical failure. In addition, like most other closed-loop linkages, the mapping of the joint space to task space and vice versa is non-trivial.
Example embodiments of the present invention therefore seek to provide a method and system that address at least one of the above mentioned problems.